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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone: (209)468-3420 Fax: (209)468-3433 Web:www.sjgov.org/ehd ABOVEGROUND PETROLEUM STORAGE PROGRAM SURVEY FORM Facility Name: Oilstop Page 3 of 3 Facility Address: City: Inspection Date: 301 W. Kettleman Lane Lodi, CA 95240 Lodi Nov 21, 2013 FA#: PR M Program Element: FA0021137 2831 Tank/Container Information Complete for all sites with cumulative aboveground storage of petroleum >_1,320 gallons in tanks*and containers**. Complete one box for each tank or each cumulative container product ty2e. ZTank (2820)1 F-1 Containers Containers: TA#:r,IAI On Containers (2821) 1 -240- Product✓ Product Type: �w Total Capacity: ga IT on'� (per tank or cumulative for containers by product type) unknown Install Date: ❑ Tank (2820) ❑ Containers (2821) #of Containers: TA#: 2 Product Type: Total Capacity: gallons (per tank or cumulative for containers by product type) Install Date: ❑ Tank (2820) ❑ Containers (2821) #of Containers: TA#: 3 Product Type: Total Capacity: gallons (per tank or cumulative for containers by product type) Install Date: ❑ Tank (2820) ❑ Containers (2821) #of Containers: TA#: 4 Product Type: Total Capacity: gallons (per tank or cumulative for containers by product type) Install Date: ❑ Tank (2820) ❑ Containers (2821) #of Containers: TA#: 5 Product Type: Total Capacity: gallons (per tank or cumulative for containers by product type) Install Date: Total Capacity this Page: 240 gallons Total Capacity for Site: 2,640 gallons Comments: EHD Inspector: Reviewed Date: Entered W--� Date: By Initial: �b l� By Initial: *Aboveground storage tank means a tank that has the capacity to store 55 gallons or moreof petroleum. —Container means a storage device designed to be moved when full. EHD 28-01 REV 04/19/12 AST SURVEY FORM